| NPI | 1336150010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 45438) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2006020756) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2022-02-24 |