| NPI | 1659516011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 251456) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN214425) | 
| Enumeration Date | 2008-12-12 | 
| Last Update Date | 2022-09-02 |