| NPI | 1215797279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 322005) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-188492) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-188492) | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-08-13 |