| NPI | 1619989662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP1605) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 5758) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2014-09-03 |