| NPI | 1518089572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK NURU964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200850097NP) |
| 163W00000X Registered Nurse (Licence: OR 200842137RN) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-09-11 |