| NPI | 1902282171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 36270.1430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992412-NP) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2019-02-01 |