| NPI | 1104336221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP10779) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN086667) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-11-17 |