| NPI | 1992011829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5375212122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014032737) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2023-11-30 |