| NPI | 1407284938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2013034483) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 76176) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2014-02-28 |