| NPI | 1629417258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75816-061) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012040372) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2015-05-22 |