| NPI | 1609415744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 235953) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN136234) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-01-06 |