| NPI | 1306330105 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 219004)  | 
| Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: AZ RN129694)  | 
| Enumeration Date | 2018-06-15 | 
| Last Update Date | 2021-09-15 |