| NPI | 1962742049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 222971) |
| Additional Taxonomies | 208VP0000X (Licence: AZ 222971) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2019-11-15 |