| NPI | 1407177157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60483962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-969A) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2021-09-07 |