| NPI | 1376652404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 45753) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-65120-081) |
| 163W00000X Registered Nurse (Licence: MO 095648) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-03-10 |