| NPI | 1649727421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6989943-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-112405-082) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2017031144) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 77691) | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2020-07-01 |