| 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 |