| NPI | 1013561182 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61254008) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22945) | 
| Enumeration Date | 2019-07-28 | 
| Last Update Date | 2022-03-02 |