| NPI | 1609313295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8160-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60726494) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60726497) | |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2021-01-14 |