| NPI | 1336212125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0001340) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 108450) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0003120) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2015-10-29 |