| NPI | 1629704200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 279235) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP050203) |
| 163W00000X Registered Nurse (Licence: AZ RN195519) | |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-09-09 |