| NPI | 1043508310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-145166) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 143102) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2011016063) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2014-09-05 |