| NPI | 1750652087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO NP990176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 129580) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2014-06-12 |