| NPI | 1710766795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61511042) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61491312) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2025-08-25 |