| NPI | 1649277922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN143483) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200150036NP) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2007-07-08 |