| NPI | 1326737735 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10008926) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61432615) | 
| Enumeration Date | 2023-05-02 | 
| Last Update Date | 2023-06-06 |