| NPI | 1184863623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2006032007) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 46311) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2018-07-31 |