| NPI | 1730877408 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61439945) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-3887) | 
| Enumeration Date | 2023-05-01 | 
| Last Update Date | 2025-09-10 |