| NPI | 1184468761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 54680) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 24913) |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |