| NPI | 1124321088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8039) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004566) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2018-03-17 |