| NPI | 1619972478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 1073) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID NP-586A) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2013-10-29 |