| NPI | 1336139369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0993418) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 13600) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 13600) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2018-05-04 |