| NPI | 1497900252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 28732.1076) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 30144) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MT 30144) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2023-12-27 |