| NPI | 1831501592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2014010129) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-76330-122) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |