| NPI | 1417346800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0991584) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 02000932) |
| 163W00000X Registered Nurse (Licence: PA 63317) | |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |