| NPI | 1649501594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AK 1128) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 30948) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2013-08-07 |