| NPI | 1720242977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60126970) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 18234) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2010-02-15 |