| NPI | 1558612358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012026926) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75808) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2013-12-11 |