| NPI | 1366095754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60979503) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WA AP60979503) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2020-12-17 |