| NPI | 1790867448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R828512) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61615792) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-10-15 |