| NPI | 1205081064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP9997) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 274083) |
| 363L00000X Nurse Practitioner (Licence: AZ RN206737) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2019-10-17 |