| NPI | 1417082553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 4741) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3278) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-10-27 |