| NPI | 1407158090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP3843) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP3843) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2015-03-03 |