| NPI | 1659372472 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP1637) | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AZ AP1637) | 
| Enumeration Date | 2005-08-02 | 
| Last Update Date | 2014-06-10 |