| NPI | 1639359417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5012) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 22049) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2015-12-17 |