| NPI | 1255889044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60684469) | 
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: WA AP60684469) | 
| Enumeration Date | 2016-09-21 | 
| Last Update Date | 2019-10-07 |