| NPI | 1063885903 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8745) | 
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: AZ RN168695) | 
| Enumeration Date | 2015-10-31 | 
| Last Update Date | 2022-06-15 |