| NPI | 1376837989 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4070)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN118161)  | 
| Enumeration Date | 2011-06-01 | 
| Last Update Date | 2011-06-03 |