NPI | 1104253210 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5230) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN145858) |
363LF0000X Nurse Practitioner, Family (Licence: HI APRN-5152) | |
Enumeration Date | 2013-10-03 |
Last Update Date | 2025-04-07 |