| NPI | 1750405767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60456289) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP 829A) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-01-09 |