| NPI | 1205021763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP2852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ RN070264) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2015-06-15 |