| NPI | 1508320706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 220904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 220904) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11006756) | |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2023-05-02 |