| NPI | 1558773598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60529422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000018492) |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2015-06-24 |