| NPI | 1043776495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 0994296) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95009644) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |