| NPI | 1063917706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP11107) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: HI APRN-5019) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11107) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-02-03 |