| NPI | 1891718516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 60779) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 74580) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |