| NPI | 1023600574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-79934-062) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2021004672) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |