| NPI | 1053788364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2015023440) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010023823) |
| 163W00000X Registered Nurse (Licence: KS 13-107980-062) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2017-11-10 |