| NPI | 1154314169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP4327) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN 1004) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-09-10 |