| NPI | 1982200804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 260688) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN195007) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2021-07-15 |