| NPI | 1063457612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201150055NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 102436) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-11-04 |