| NPI | 1487807970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 46296) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 079101) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2009-03-09 |