| NPI | 1992174775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61201082) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 291976) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2022-01-26 |