| NPI | 1710316682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60404993) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 71248) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2017-02-27 |