| NPI | 1316924392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 878) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AK 878) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2017-12-29 |