| NPI | 1578501383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76333) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 143435) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-11-24 |