| NPI | 1922602770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61268308) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 41811) |
| 363L00000X Nurse Practitioner (Licence: ID 66514) | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2022-11-03 |