| NPI | 1922856178 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61595884)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 68966)  | 
| Enumeration Date | 2024-05-10 | 
| Last Update Date | 2024-09-20 |