| NPI | 1639612617 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60642418) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004219) | 
| Enumeration Date | 2016-11-23 | 
| Last Update Date | 2018-08-07 |