| NPI | 1790044188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 201200851) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75489) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2012-05-07 |