| NPI | 1619285400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2010032711) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 75374) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2022-07-21 |