| NPI | 1184562365 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60781459) |
| 163W00000X Registered Nurse (Licence: OR 10015439) | |
| Enumeration Date | 2026-03-23 |
| Last Update Date | 2026-08-25 |