| NPI | 1457605685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95012468) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OH A1012066) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.0991597-NP) | |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2020-01-03 |