| NPI | 1649897091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 240969) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: AZ RN240969) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2023-10-03 |