| NPI | 1740596303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0993737) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 75199) |
| 363L00000X Nurse Practitioner (Licence: CO 0993737) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2018-04-11 |