| NPI | 1609132505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP5244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN148916) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2017-01-13 |