| NPI | 1194392951 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ RNP258420)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 258420)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 258420)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ RNP258420)  | |
| Enumeration Date | 2021-06-09 | 
| Last Update Date | 2023-09-25 |