| NPI | 1174964266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0991662-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17692) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2015-10-08 |