| NPI | 1083881262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 23899-0963) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000529) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 23899) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2011-11-01 |