| NPI | 1912556051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 66529) |
| 163W00000X Registered Nurse (Licence: KS 13-140598-122) | |
| 363L00000X Nurse Practitioner (Licence: FL APRN11018677) | |
| 363L00000X Nurse Practitioner (Licence: KS 79276) | |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2022-08-01 |