| NPI | 1386721397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP225255) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704180804) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-10-20 |