| NPI | 1922335579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 21062.1024) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 21062.1024) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2012-01-11 |