| NPI | 1083392690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 52983) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 41464) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-08-30 |