| NPI | 1700409018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61006337) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ID 62841) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |