| NPI | 1639361462 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007873) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA IT40000985) | 
| Enumeration Date | 2007-08-15 | 
| Last Update Date | 2021-04-05 |