| NPI | 1174688170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 1157) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN111109) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2018-01-05 |