| NPI | 1922582170 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9488416)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60914410)  | 
| Enumeration Date | 2018-09-23 | 
| Last Update Date | 2023-04-27 |