| NPI | 1124793948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 279804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014751) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014751) | |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2023-05-19 |