| NPI | 1497839666 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 618) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN 060621) | 
| Enumeration Date | 2006-10-25 | 
| Last Update Date | 2023-04-05 |