| NPI | 1114585726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 233799) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN211139) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ F08190922) | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2021-04-27 |