| NPI | 1558712414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 45463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6948805-4405) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2022-08-31 |