| NPI | 1669664769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6966-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN144584) |
| 363L00000X Nurse Practitioner (Licence: AZ AP2766) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2021-01-15 |