| NPI | 1205179561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OK 87323) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2013041943) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-12-03 |