| NPI | 1861857039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60892172) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-51475) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1679A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AR A005021) | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2021-06-17 |