| NPI | 1639855422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61464080) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA RN60960163) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-09-19 |