| NPI | 1679139539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0994753-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1632938) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-09-11 |