| NPI | 1790035921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9308421) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL 9308421) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CO C-APN.0001192-C-NP) | |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2020-04-01 |