| NPI | 1629574512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0202308) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 4468) |
| 163W00000X Registered Nurse (Licence: CO 0202308) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2019-03-25 |