| NPI | 1710318654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201403441NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60479342) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2016-07-11 |