| NPI | 1063029700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 246858) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 86115) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017422) | |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2025-11-25 |