| NPI | 1912950866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 079217) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 079217) |
| 363L00000X Nurse Practitioner (Licence: KS 44691) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-11-19 |