| NPI | 1275919698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-089891) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN195646) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2018-07-06 |