| NPI | 1497906465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011000344) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 13-90603-82) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2011-10-07 |