| NPI | 1487893509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 59118) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CO 59118) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |