| NPI | 1457845240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 54690) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60865071) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2020-11-17 |