| NPI | 1235436916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011003654) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75320-122) |
| 363L00000X Nurse Practitioner (Licence: KS 53-75320-122) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011003654) | |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2021-01-21 |