| NPI | 1891318549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61193132) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: MN R2146878) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2022-10-04 |