| NPI | 1871649129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60691567) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 6021763-4405) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2019-05-06 |