| NPI | 1336676113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP10172) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN189752) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ RN189752) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-09-12 |