| NPI | 1700341831 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 221696)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN126238)  | 
| Enumeration Date | 2019-02-03 | 
| Last Update Date | 2024-09-15 |