| NPI | 1376033027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018012263) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-78149-081) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-06-05 |