| NPI | 1972860815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP60284256) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60284256) |
| 363L00000X Nurse Practitioner (Licence: VA AP60284256) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2020-11-14 |