NPI | 1770035248 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R232956) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60790736) |
363L00000X Nurse Practitioner (Licence: WA RN60790807) | |
Enumeration Date | 2016-10-31 |
Last Update Date | 2019-05-22 |