| NPI | 1063592509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP0852) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN058536) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-05-01 |