| NPI | 1568129948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 240922) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA 61207130) |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2024-05-10 |