| NPI | 1396513529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61512346) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10022708) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-10-11 |