| NPI | 1629123419 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30004844)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: WA RN00058893)  | 
| Enumeration Date | 2007-01-24 | 
| Last Update Date | 2012-01-27 |