| NPI | 1689918765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60461338) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012476) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP012476) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60461338) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2016-03-15 |