| NPI | 1659677821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 38381.1545) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 95666) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2020-09-30 |