| NPI | 1851456735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2002022317) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-94030-052) |
| 363L00000X Nurse Practitioner (Licence: KS 45930) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2022-01-18 |