| NPI | 1679244685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 182981) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9029118-3102) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-11-02 |