| NPI | 1972868677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP4549) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ TAP4549) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-08-03 |