| NPI | 1386831626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75533-061) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 113747) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-03-20 |