| NPI | 1255600615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN69366) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2019-08-06 |