| NPI | 1598961641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200750063NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA IT40000989) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007768) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-06-16 |