| NPI | 1396722054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 107415) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 45787) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2019-05-20 |