| NPI | 1740541630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 201211955) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 144900) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |