| NPI | 1750583019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 5881) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 346877-4405) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-03-07 |