| NPI | 1780194753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 10291) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10291) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2018-05-30 |