| NPI | 1578846895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4208)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP2389)  | 
| Enumeration Date | 2011-09-22 | 
| Last Update Date | 2019-09-12 |