| NPI | 1417286840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009033161) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-96207-102) |
| 163W00000X Registered Nurse (Licence: MO 2007024272) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-74977-102) | |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2020-06-22 |