| NPI | 1285981399 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN047495) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4276) | 
| Enumeration Date | 2012-08-08 | 
| Last Update Date | 2025-04-22 |