| NPI | 1598848681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 31031-1594) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WY 610) |
| 163WG0600X Registered Nurse, Gerontology (Licence: CO 1665376) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-12-12 |