| NPI | 1588985600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010009581) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375104012) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2012-01-17 |