| NPI | 1053004630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61481461) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61447768) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2025-07-31 |