| NPI | 1891806428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA AP30005126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30005126) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-01-25 |