| NPI | 1407091978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4827) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 161156) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3644) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2021-04-09 |