| NPI | 1366791782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 61226935) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 13467) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-10-22 |