| NPI | 1932082104 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RNP328110) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: AZ RN193394) |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-08-16 |