| NPI | 1912065129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 0052805) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 119634) |
| 207R00000X Internal Medicine (Licence: NC 165227) | |
| 363L00000X Nurse Practitioner (Licence: CO 2702) | |
| 164W00000X Licensed Practical Nurse (Licence: CO 119634) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2013-07-29 |