| NPI | 1568887503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP1421A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP1421A) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60446914) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2020-04-13 |