| NPI | 1477554863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 114192) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 114192) |
| 163W00000X Registered Nurse (Licence: KS 1465131021) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 44752) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-03-19 |