| NPI | 1235280678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 131048) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 74150) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2022-07-21 |