| NPI | 1972534725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP30003691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30003691) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP30003691) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-10-16 |