| NPI | 1396350898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 46489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 46489) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2022-11-02 |