| NPI | 1801493275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020031429) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 140231) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2020031429) | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2021-08-30 |