| NPI | 1114104874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 3543) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30 304786) |
| 363L00000X Nurse Practitioner (Licence: AZ RN160935) | |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2023-07-12 |