| NPI | 1821170051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WY 1146) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ AP3293) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2021-09-14 |