| NPI | 1619392123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP30003227) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN0077001) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2014-02-20 |