| NPI | 1730515313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 990889) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 6186261-3102) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2014-05-27 |