| NPI | 1043618465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO MISSOURI) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76503-122) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2023-10-19 |