| NPI | 1083860258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2017008859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017008859) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 45171) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2017-10-19 |