| NPI | 1649042029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61469814) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA AP61469814) |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |