| NPI | 1417625930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0996814-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2319819) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F348435-01) | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2022-11-07 |