| NPI | 1831612761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0996400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 709537) |
| 163W00000X Registered Nurse (Licence: MD 709537) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 342677) | |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2023-02-15 |