| NPI | 1730551516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1646A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60600640) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2020-01-05 |