| NPI | 1144625914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76533) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-76533-041) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2014033141) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2017-04-18 |