| NPI | 1902325558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 124871) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 124871) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AK 124871) | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2025-02-11 |