| NPI | 1144031923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 318119) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ F12240758) | 
| 163W00000X Registered Nurse (Licence: AZ RN166375) | |
| Enumeration Date | 2025-01-20 | 
| Last Update Date | 2025-10-11 |