| NPI | 1790118537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 76078) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 113417) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2022-11-02 |