| NPI | 1982868667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 22181.1080) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 2177707-4405) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2016-01-26 |