| NPI | 1205492584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 44515) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 34354) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-08-27 |