| NPI | 1861784910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011007384) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5375329051) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75329-051) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2015-12-03 |