| NPI | 1073712279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 212-000372) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 21200372) |
| 208000000X Pediatrics (Licence: WY 21200372) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 21200372) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2010-08-26 |