NPI | 1912443128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60723994) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60723994) |
363LF0000X Nurse Practitioner, Family (Licence: ID 54740) | |
Enumeration Date | 2017-01-11 |
Last Update Date | 2022-10-05 |