| NPI | 1669854998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60620386) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128364) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2020-12-07 |