| NPI | 1619333242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA 60609526) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 60609062) |
| 163W00000X Registered Nurse (Licence: TN 0000203124) | |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |