| NPI | 1124724760 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 297528) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 297528) | 
| 363L00000X Nurse Practitioner (Licence: NM 71397) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 71397) | |
| Enumeration Date | 2023-02-06 | 
| Last Update Date | 2023-10-11 |