| NPI | 1356964522 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 243263)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ F05200509)  | 
| Enumeration Date | 2020-05-22 | 
| Last Update Date | 2024-10-08 |