| NPI | 1225332588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010026979) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75266-061) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2011-04-27 |