| NPI | 1952625345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2009038851) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75086-112) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2017-02-17 |