| NPI | 1588945661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ RN128705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP4186) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2013-07-22 |