| NPI | 1386262392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WY 48246) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 16686) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WY 48246) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2023-03-28 |