| NPI | 1184806382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP2854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 111603) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 200950086NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F341031) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2018-07-18 |