| NPI | 1023240785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO TL0006055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-964) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-RX 251) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2020-03-22 |