| NPI | 1952936932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 45942) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 45942) |
| 163W00000X Registered Nurse (Licence: WY 34008) | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2022-11-03 |