| NPI | 1821043043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP3056) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN152831) |
| 363L00000X Nurse Practitioner (Licence: NY F333256-1) | |
| 363L00000X Nurse Practitioner (Licence: NY 473069) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-05-29 |