| NPI | 1912456344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0001790-C-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 209337) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA F0916929) | |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2020-02-26 |