| NPI | 1588772461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30006968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP1021A) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2021-08-18 |