| NPI | 1316354590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 36815.1473) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704293226) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 36815.1473) | |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2019-09-04 |