| NPI | 1558399402 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ RN049228) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ rn049228) | 
| Enumeration Date | 2006-06-29 | 
| Last Update Date | 2007-07-08 |