| NPI | 1982601498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R31359) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 114012) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2024-08-01 |