| NPI | 1609423300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 61086885) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 61072510) |
| 163W00000X Registered Nurse (Licence: NY 758195) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2020-07-12 |