| NPI | 1265831523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76483) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015001958) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2021-12-06 |