| NPI | 1063739456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP3663) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN139217) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-06-22 |