| NPI | 1780214551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79067-071) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0997440-NP) |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2022-05-19 |