| NPI | 1396120648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8743) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 0169154) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172810) | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2017-03-07 |