| NPI | 1043660764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016033604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-133001-122) |
| 163W00000X Registered Nurse (Licence: MO 2011017930) | |
| 363L00000X Nurse Practitioner (Licence: KS 77403) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2017-11-15 |