| NPI | 1639269533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: WA AP30002106) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00098061) |
| 363A00000X Physician Assistant (Licence: WA PA10002776) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-09-15 |