| NPI | 1669773305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN150480) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5072) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2013-07-12 |