| NPI | 1649780495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 171228) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8281680-4405) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2021-03-26 |