| NPI | 1639263650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 26461.0975) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 33320) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-11-15 |