| NPI | 1295769180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 089525) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AK 117500) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-11-18 |