| NPI | 1740862804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA AP61087783) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP61087783) |
| 163W00000X Registered Nurse (Licence: WA AP61087783) | |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2023-01-31 |