| NPI | 1083346233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 50460) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 41786) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-07-18 |