| NPI | 1902150543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2012032157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83178-112) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2024-06-04 |