| NPI | 1770958639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP10273) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN170043) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2019-04-24 |