| NPI | 1962813592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60579127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125360) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2021-03-12 |