| NPI | 1174081715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2018032269) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 78424) |
| Enumeration Date | 2019-03-02 |
| Last Update Date | 2020-02-22 |