| NPI | 1508379504 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10601) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN166497) | 
| Enumeration Date | 2017-11-13 | 
| Last Update Date | 2020-09-09 |