| NPI | 1679975700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10376636-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60497304) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2022-07-21 |