| NPI | 1760767412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60249014) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP-1128A) |
| 363LF0000X Nurse Practitioner Family (Licence: ID 23519) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2023-01-12 |