| NPI | 1972046118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61012061) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174356) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2019-12-20 |