| NPI | 1629464631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2015008081) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-76748-111) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2015008081) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-76748-111) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015008081) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-76748-111) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2016-02-29 |