| NPI | 1760512602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 4468) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 130776) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-06-22 |