| NPI | 1669913562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-122826) |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2022-02-09 |