| NPI | 1104274505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8804) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 179844-30) |
| 363L00000X Nurse Practitioner (Licence: AZ AP8804) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2025-11-06 |