| NPI | 1003339268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 71924) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN166862) |
| 363L00000X Nurse Practitioner (Licence: AZ AP10354) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-05-09 |