| NPI | 1104161405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012022147) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2012022147) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9454295) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 77949) | |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2022-08-25 |