| NPI | 1669198859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 300419) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10002261) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2024-05-16 |