| NPI | 1699771659 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2892) | 
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: AZ RN056532) | 
| Enumeration Date | 2005-06-23 | 
| Last Update Date | 2021-06-04 |