| NPI | 1033119938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 138186) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 138186) |
| 163W00000X Registered Nurse (Licence: KS 14-73960-062) | |
| 363LF0000X Nurse Practitioner Family (Licence: KS 45598) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2011-04-18 |