| NPI | 1053756403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5308) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 1971656) |
| 163W00000X Registered Nurse (Licence: AZ RN148673) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2025-10-13 |