| NPI | 1093965063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0002619) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 18907.0986) |
| 363L00000X Nurse Practitioner (Licence: WY 18907) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 986) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 987) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2023-07-25 |