| NPI | 1295002400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4468) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75470-121) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2011032580) | |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2020-08-07 |