| NPI | 1902193220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4110) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP4110) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2018-04-04 |