| NPI | 1659653343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 143683) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: AK R26293) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2019-04-05 |