| NPI | 1104344498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017025891) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-77819-032) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |