| NPI | 1710409222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60794554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 187523) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22740) | |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2020-10-15 |