| NPI | 1366906950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ RN169554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ AP11623) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ RN169554) | |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2020-09-03 |