NPI | 1043804743 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ RNP2623646) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RNP2623646) |
163W00000X Registered Nurse (Licence: AZ RN156754) | |
Enumeration Date | 2021-02-23 |
Last Update Date | 2024-12-18 |