| NPI | 1821471624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RNP256830) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN189383) | 
| 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: AZ RN189383) | |
| Enumeration Date | 2015-06-30 | 
| Last Update Date | 2021-04-20 |