| NPI | 1750602256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 990708) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R172946) |
| 363L00000X Nurse Practitioner (Licence: AL 1-135203) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2014-08-21 |