| NPI | 1053850701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017024398) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013023605) |
| 363L00000X Nurse Practitioner (Licence: KS 53-77782-122) | |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2019-10-15 |