| NPI | 1366054488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R219997) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61087573) |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2023-09-11 |