NPI | 1295093391 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 234445) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP048164) |
164X00000X Licensed Vocational Nurse (Licence: CA VN239747) | |
Enumeration Date | 2012-04-25 |
Last Update Date | 2022-04-28 |