| NPI | 1275579682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020016186) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-45357) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 45357) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-03-27 |