| NPI | 1154772721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP8740) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN205716) |
| 363L00000X Nurse Practitioner (Licence: IA MLS127733IA) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2021-07-13 |