| NPI | 1548822562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ F11190862) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN196642) |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2021-02-03 |