| NPI | 1053611301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-APN.0000561-C-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006707) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2020-01-06 |