| NPI | 1104341759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.209016117) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209-016117) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |