| NPI | 1487114054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 235841) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ RN175650) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-09-27 |