| NPI | 1538688015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 1657) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 30331.1657) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-12-06 |