NPI | 1730551862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60856996) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173010) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2019-10-10 |