| NPI | 1073863684 |
|---|---|
| Former Name | SALLY CECILE USTBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7727) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1668894) |
| 363L00000X Nurse Practitioner (Licence: WI 160229) | |
| 363L00000X Nurse Practitioner (Licence: MN 0702) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2021-10-12 |