| NPI | 1902247372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0996821-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338511) |
| 163W00000X Registered Nurse (Licence: NY 658042) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2022-05-13 |