| NPI | 1013209188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011009484) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5375392021) |
| 363L00000X Nurse Practitioner (Licence: MO 2011009484) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2023-07-08 |