| NPI | 1205218302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 7819) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN112020) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7819) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2020-09-10 |