| NPI | 1912104183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 118390) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704234535) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-09-29 |