| NPI | 1770574345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 119635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60225695) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-03-18 |