| NPI | 1063021137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 10024575) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61085962) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61085962) | |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2025-10-23 |