| NPI | 1104069566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CO APN.0004599-NP)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 120357)  | 
| Enumeration Date | 2009-04-15 | 
| Last Update Date | 2018-10-17 |