| NPI | 1730468018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015002155) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015002155) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2015002155) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 823141) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 105935) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2019-11-21 |