| NPI | 1063276970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 218513) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 218513) | 
| Enumeration Date | 2024-02-12 | 
| Last Update Date | 2025-03-14 |