| NPI | 1629336979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 44363) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 990372) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-11-04 |