| NPI | 1154667913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 373) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 34375) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |