| NPI | 1104315167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60909982) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60766315) |
| Enumeration Date | 2018-05-05 |
| Last Update Date | 2019-01-03 |