| NPI | 1568128775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WA AP61226742) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60270828) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2022-04-15 |