| NPI | 1891048450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO APN.0995670-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 646762) |
| 163W00000X Registered Nurse (Licence: CO RN.1669166) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382368) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 50864) | |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2022-11-04 |