| NPI | 1609903160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 45978) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2002023976) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |