NPI | 1508402207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61194658) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60478347) |
Enumeration Date | 2019-11-18 |
Last Update Date | 2021-07-12 |