| NPI | 1366899684 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112687)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO RN.1620370)  | 
| 363L00000X Nurse Practitioner (Licence: CO APN.0992527)  | |
| Enumeration Date | 2016-05-17 | 
| Last Update Date | 2018-12-31 |