| NPI | 1407623135 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61501577)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 61501577)  | 
| Enumeration Date | 2023-12-04 | 
| Last Update Date | 2024-07-05 |