| NPI | 1659674208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992482-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.11950NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 16459) | |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2016-12-27 |