| NPI | 1215719026 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 300582)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN172439)  | 
| Enumeration Date | 2023-10-17 | 
| Last Update Date | 2025-10-06 |