| NPI | 1780805556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201150155NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 24809) |
| 363L00000X Nurse Practitioner (Licence: AK 863) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-01-23 |