| NPI | 1508113408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201401076NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 204271) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0990427-NP) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2014-06-27 |