| NPI | 1386622660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ RN035539) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP0863) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2012-02-08 |