| NPI | 1104139781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2009009098) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 14107876042) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2022-01-27 |