| NPI | 1407185796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 75069) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2009035956) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2015-08-08 |