| NPI | 1104401157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 96070) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0105195) |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2022-01-28 |