| NPI | 1578170692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-79640-121) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2020029662) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |