| NPI | 1205011079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2005005086) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 46081) |
| Enumeration Date | 2007-12-29 |
| Last Update Date | 2016-04-19 |