| NPI | 1558610915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012009890) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75667-122) |
| 163W00000X Registered Nurse (Licence: MO 2000161010) | |
| 163W00000X Registered Nurse (Licence: KS 14-112336-122) | |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2013-07-23 |