| NPI | 1255547311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 45726) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 150752) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2010-11-03 |