| NPI | 1407415581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-153968) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60971063) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-10-29 |