| NPI | 1083094759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 8436)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0991790-NP)  | 
| Enumeration Date | 2015-06-08 | 
| Last Update Date | 2018-06-15 |