| NPI | 1629191705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP2626) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AK 1004) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2016-11-04 |