| NPI | 1518510874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 235295) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 105766) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-08-26 |