| NPI | 1104425073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 166918) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: AK 38066) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2025-01-21 |