| NPI | 1790546562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 302255) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 35521) |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |