| NPI | 1770047755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5379553101) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012030635) |
| 163W00000X Registered Nurse (Licence: KS 14-116606-101) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2020033504) | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-11-09 |