| NPI | 1679884761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61473911)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN104462-AP06137)  | 
| Enumeration Date | 2010-06-23 | 
| Last Update Date | 2025-06-09 |