| NPI | 1104018274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0991323-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN095827) |
| 363L00000X Nurse Practitioner (Licence: AZ AP2846) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2021-07-15 |