| NPI | 1639417314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN261421) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP4775) |
| 163W00000X Registered Nurse (Licence: AZ RN158105) | |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2016-08-24 |