| NPI | 1356964464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 47173) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: WY 22963) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2021-05-13 |