| NPI | 1538617147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 260162) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN RN-232548-2) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2025-05-20 |