| NPI | 1891996013 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP0271) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ RN076721) | 
| 163W00000X Registered Nurse (Licence: AZ RN076721) | |
| Enumeration Date | 2007-05-29 | 
| Last Update Date | 2009-06-19 |