| NPI | 1679099816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 125877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6912) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-07-21 |