| NPI | 1003984048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2007011119) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4065P) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-02-07 |