| NPI | 1043250541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP5303) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN183790) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 900201) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-04-21 |