| NPI | 1104842806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ NP12) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ NP183) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2012-02-16 |