| NPI | 1316243447 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8766) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011003374) | 
| Enumeration Date | 2011-02-08 | 
| Last Update Date | 2017-02-22 |