| NPI | 1740744952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 60968531) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 62001) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201906334NP-PP) | |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-08-03 |