| NPI | 1891756433 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ NP188)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN056121)  | 
| Enumeration Date | 2006-03-31 | 
| Last Update Date | 2010-06-02 |