| NPI | 1861401580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 74940) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2016017867) |
| 363L00000X Nurse Practitioner (Licence: CO APN.0990774-NP) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-10-06 |