| NPI | 1699319483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60998181) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 59364) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2023-08-01 |