| NPI | 1629703731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61340381)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61075632)  | 
| Enumeration Date | 2022-07-21 | 
| Last Update Date | 2023-04-24 |