| NPI | 1790115905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AZ AP5287) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP5287) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2019-10-03 |