| NPI | 1033153804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO 63998) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 109125-22) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |