| NPI | 1619990751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 44219) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 0920102) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-12-19 |