| NPI | 1295165918 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60995291)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R180442)  | 
| Enumeration Date | 2013-11-15 | 
| Last Update Date | 2025-10-20 |