| NPI | 1356602569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 200826403) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375689032) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2014-08-12 |