| NPI | 1043660392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011018481) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 14-120808-092) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2017-11-09 |