| NPI | 1396399440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 53971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 29827) |
| Enumeration Date | 2019-07-27 |
| Last Update Date | 2024-06-21 |