| NPI | 1104018738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 5335) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 51885) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2012-08-14 |