| NPI | 1689940066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP4412) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: AZ AP4412) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2022-12-09 |