| NPI | 1487955357 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP3859) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN111149) | 
| Enumeration Date | 2010-11-09 | 
| Last Update Date | 2012-01-04 |