| NPI | 1962043075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 301631) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP001644) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2024-03-07 |