| 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) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2024-05-08 |