| NPI | 1679792634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 15556.1811) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 152467) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2018-12-31 |