| NPI | 1972120798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 275658) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 288126) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5013852) | |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2022-06-10 |