| NPI | 1639275365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60455438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 675750) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-09-24 |