| NPI | 1124018437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MO 105599) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: KS 75874) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: KS 74692) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2021-11-29 |