| NPI | 1790074763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0992893-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 20563) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2023-03-07 |