| NPI | 1306896675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45013) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 123237) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2010-03-16 |