| NPI | 1053083725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 219489) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021039964) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2024-12-17 |