| NPI | 1730512039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60408392) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID NP-1298A) |
| Enumeration Date | 2013-08-10 |
| Last Update Date | 2020-10-19 |