| NPI | 1609312008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 205200) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60702221) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60702221) | |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2021-10-21 |