| NPI | 1073632360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AK NURU1552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK NURU1552) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-02-03 |