| NPI | 1225444052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5699)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN158483)  | 
| Enumeration Date | 2014-07-01 | 
| Last Update Date | 2018-11-29 |