| NPI | 1558670117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 268330) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP046747) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2022-04-12 |