| NPI | 1841435385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 465) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WY PENDING) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2009-10-19 |