| NPI | 1366695348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021038560) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 46302) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2004004105) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2021-10-12 |