| NPI | 1073525150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 43087) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4708) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-04-04 |