| NPI | 1962427658 |
|---|---|
| Former Name | MARY THERESA BOLLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: WA AP30006303) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00089718) |
| 363L00000X Nurse Practitioner (Licence: WA AP30006303) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-11-08 |