| NPI | 1982614723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 18217.0308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 363542-4405) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-10-04 |