| NPI | 1104570043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 271697) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN109461) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80957-071) | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2023-11-06 |