| NPI | 1194492306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 262885) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TEMP262885) | 
| Enumeration Date | 2021-08-25 | 
| Last Update Date | 2023-03-07 |