| NPI | 1790169431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: WY 1421) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 36083.1421) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0991472-NP) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-07-22 |