| NPI | 1619160454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 990147) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 335219) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2011-08-05 |