| NPI | 1245586494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK No. 1150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 345328) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2020-04-29 |