| NPI | 1255879110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 219643) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ Rn168875) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2019-03-04 |