| NPI | 1972831741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60514702) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 14550) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60514702) | |
| Enumeration Date | 2009-12-06 |
| Last Update Date | 2016-12-14 |