| NPI | 1629546502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 261975) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011188) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2024-03-28 |