| NPI | 1215134507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75648-122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 366935-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ RN117988) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2012017311) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-10-25 |