| NPI | 1679968002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 76726) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2015005079) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |