| NPI | 1447560321 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 3756) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 132854) | 
| Enumeration Date | 2010-10-13 | 
| Last Update Date | 2012-07-12 |