| NPI | 1659485779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 0080044557N1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30003524) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-10 |