| NPI | 1831611151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017017453) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: KS 14-106606-081) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-07-07 |