| NPI | 1265494587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30006176)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200250032NP)  | 
| Enumeration Date | 2006-04-03 | 
| Last Update Date | 2014-02-18 |