| NPI | 1114761236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 308373) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 308373) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 308373) | |
| 363L00000X Nurse Practitioner (Licence: AZ 308373) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2026-03-16 |