| NPI | 1336614247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 1825) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 36066) |
| Enumeration Date | 2018-10-06 |
| Last Update Date | 2018-11-09 |