| NPI | 1023489192 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP8168) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP8168) | 
| Enumeration Date | 2015-10-14 | 
| Last Update Date | 2019-06-12 |