| NPI | 1194081398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2012009191) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 82394) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2023-10-03 |