| NPI | 1003812918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013010843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44778) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2013-07-31 |