| NPI | 1700263555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60733421) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 100632) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 19888) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2022-02-09 |