| NPI | 1861704702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 16879.1233) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: WY 16879) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2015-03-19 |