| NPI | 1740705961 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11544) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN182545) | 
| Enumeration Date | 2017-08-09 | 
| Last Update Date | 2018-09-21 |