| NPI | 1578689964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30003055) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA RN00067431) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-24 |