| NPI | 1235522129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 7627) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN156760) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7627) | |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2020-09-03 |