| NPI | 1003186719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 75490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009037503) |
| 163W00000X Registered Nurse (Licence: KS 100732) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2012026433) | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2022-07-21 |