| NPI | 1093147704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO C-APN.0002601-C-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP013625) |
| 363L00000X Nurse Practitioner (Licence: CA 23349) | |
| 363L00000X Nurse Practitioner (Licence: VA 0024178726) | |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2022-08-03 |