| NPI | 1902652449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 43002) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WY 43002) |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-08-29 |