| NPI | 1588763569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.0004057-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 23001.365) |
| 363L00000X Nurse Practitioner (Licence: CO 4057) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-12-15 |