| NPI | 1720507171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60919669) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175378) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2019-03-13 |