| NPI | 1710176623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0005431-NP) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 165824) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2021-03-31 |