| NPI | 1619500089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 238308)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ F01201240)  | 
| 363L00000X Nurse Practitioner (Licence: AZ 238308)  | |
| Enumeration Date | 2020-02-13 | 
| Last Update Date | 2022-08-24 |