| NPI | 1124732086 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 287027)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN186192)  | 
| Enumeration Date | 2023-01-05 | 
| Last Update Date | 2025-04-09 |