| NPI | 1649785312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60799109) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 57247) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2021-07-02 |