| NPI | 1174518021 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30003996)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA AP30003996)  | 
| Enumeration Date | 2005-09-16 | 
| Last Update Date | 2018-05-22 |