| NPI | 1861884264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO F0215537) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11770-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS F0215537) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO F0215537) | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2022-12-12 |