| NPI | 1770071573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61648502) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10052339) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 24514A) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2025-11-21 |