| NPI | 1467705921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP0764780) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 778539) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2018-03-17 |