| NPI | 1366867400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 991016) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76276) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2016-11-16 |