| NPI | 1710264304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP 60264610) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 675028) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2021-02-26 |