| NPI | 1154860765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10893) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 32542.1595) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2018-11-14 |