| NPI | 1578621991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CO 182212) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 259234) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-03-17 |