| NPI | 1245462423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004035580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375103101) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2015-05-19 |