| NPI | 1922667658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA AP60966088) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10022404) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2025-10-20 |