| NPI | 1821171364 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 875)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 24934)  | 
| Enumeration Date | 2006-10-20 | 
| Last Update Date | 2023-03-07 |