| NPI | 1295069268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 134220) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75016) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |