| NPI | 1649842998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61195399) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP61195399) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2022-11-03 |