| NPI | 1104344969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10091) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP10091) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-10-20 |