| NPI | 1912067489 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0106X Nurse Practitioner, Occupational Health (Licence: AZ AP4480) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MT RN23513) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9330687) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2025-01-15 |