| NPI | 1558443408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK NURU650) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 650) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP15559) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-01-24 |