| NPI | 1386139236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 29402.1813) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 29402) |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2020-01-23 |