| NPI | 1861748832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60411118) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 98811) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 005605) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2020-12-07 |