| NPI | 1609975341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 46019) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 74166) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2015-04-27 |