| NPI | 1083003552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015002153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA TEMPAPRN0102) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-76667-062) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-76667-062) | |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2021-01-25 |