| NPI | 1053373522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 990011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 04-45738) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2011-05-02 |