| NPI | 1003880568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP140213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 14421) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 3557) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2010-01-19 |