| NPI | 1063599488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 44697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO MO-055686) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-02-11 |