| NPI | 1720515497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-78333-101) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2017029819) |
| 363L00000X Nurse Practitioner (Licence: MO 2017029819) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2023-11-02 |