| NPI | 1760559876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 259100960) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 66580) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-07-02 |