| NPI | 1104066471 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP3437) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN133607) | 
| Enumeration Date | 2009-02-26 | 
| Last Update Date | 2025-07-15 |