| NPI | 1265667190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 5964) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 5964) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2014-06-26 |