| NPI | 1700540697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 266168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61599650) |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2025-04-17 |