| NPI | 1952306516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 152375) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2007-07-08 |