| NPI | 1578955530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 226667) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19558) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2019-06-20 |