| NPI | 1760624076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 4680) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 112133) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2013-04-17 |