| NPI | 1942347398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011017384) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45954) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-06-27 |