| NPI | 1467868810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-76386-022) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2014024623) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-11-17 |