| NPI | 1649727611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202104711NP)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60661309)  | 
| Enumeration Date | 2016-09-07 | 
| Last Update Date | 2024-06-27 |