| NPI | 1104502590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 247646) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 247646) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-11-01 |