| NPI | 1689070807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA 363L00000X) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: ID NP-1515A) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2021-06-02 |