| NPI | 1699791251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 45880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004024623) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2012-06-20 |