| NPI | 1356394738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 45256) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45256) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-07-02 |