| NPI | 1497994123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1502A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 160447) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2016-11-15 |