| NPI | 1679808109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8932) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 19402) | 
| Enumeration Date | 2009-10-16 | 
| Last Update Date | 2024-10-16 |