| NPI | 1336625201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9314513) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60857008) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2020-09-01 |