| NPI | 1043614795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 295601) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 6570110-4405) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2023-08-28 |