| NPI | 1710714258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 315555) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: AZ 152882) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2026-09-16 |