| NPI | 1063756450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO C-APN.0000206-C-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5157) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 5157) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2015-12-15 |