| NPI | 1134772148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61013200)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60549168)  | 
| Enumeration Date | 2019-07-18 | 
| Last Update Date | 2021-04-02 |