| NPI | 1285770305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 20234.0234) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 124523) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-09 |