| NPI | 1194996892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2000163262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-74929-072) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2024-06-18 |