| NPI | 1336184654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 105030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45594) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2011-04-07 |