| NPI | 1518358688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76717) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015001138) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2021-10-11 |