| NPI | 1437379534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 135354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45500) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |