| NPI | 1417457565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018012678) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011030236) |
| 163W00000X Registered Nurse (Licence: KS 14118145021) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 78106) | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-04-14 |