| NPI | 1568804664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 16225.1253) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO APN0990783) |
| 363L00000X Nurse Practitioner (Licence: CO apn0990783) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2018-09-21 |