| NPI | 1104037225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0001257) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 44443) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-03-06 |