| NPI | 1275205254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 264456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 264456) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 264456) | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-11-05 |