| NPI | 1104809532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0320421-22) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 160696) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2025-09-11 |