| NPI | 1982391058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 290672) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 290672) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2024-06-03 |