| NPI | 1104459833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KS 5379289071)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MO 2020007316)  | 
| Enumeration Date | 2020-02-21 | 
| Last Update Date | 2021-07-12 |