| NPI | 1568354900 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP70029264) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: WA 61090915) |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-08-12 |