| NPI | 1700262763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 206920) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8007) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2023-07-19 |