| NPI | 1912466392 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA N361139398)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-166227)  | 
| 363L00000X Nurse Practitioner (Licence: WA N261129295)  | |
| Enumeration Date | 2019-03-15 | 
| Last Update Date | 2021-02-18 |