| NPI | 1053691055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 1248) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 1248) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |