| NPI | 1902957616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 140573) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-45989-012) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2018-02-06 |