| NPI | 1043569304 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CO APN.0990453-NP) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 189817) | 
| Enumeration Date | 2012-09-02 | 
| Last Update Date | 2015-11-12 |