| NPI | 1053644534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 74951) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2002008628) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2014-01-13 |