| NPI | 1497753586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP10884) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN211833) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 156655) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2018-10-16 |