| NPI | 1700887502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R163105) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 88082) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-11-06 |