| NPI | 1336629518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60859799) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 60162) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2021-04-02 |