NPI | 1639618705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WA AP60849146) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60849146) |
363LF0000X Nurse Practitioner, Family (Licence: CO 0992951) | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2024-05-31 |