| NPI | 1629307202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 305957) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 658920) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 658920) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2025-01-07 |