| NPI | 1053755223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 279267) |
| Additional Taxonomies | 176B00000X Midwife (Licence: AZ LM188) |
| 363L00000X Nurse Practitioner (Licence: IA H164740) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IA 147175) | |
| 164W00000X Licensed Practical Nurse (Licence: AZ LP047069) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-01-23 |