| NPI | 1003297599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 266302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 657642) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 339705) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2023-07-14 |