| NPI | 1750040812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 275080) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A166735) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2022-10-03 |