| NPI | 1447298229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 14-63595-102, 44226) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 077793) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-07-08 |