| NPI | 1003360652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 0992217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1633055) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |