| NPI | 1942973656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 260085) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2023-04-12 |