| NPI | 1508379504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP10601) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN166497) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10601) | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2025-11-03 |