| NPI | 1043548696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76173K) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2000148328) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2000148328) | |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2016-04-19 |