| NPI | 1922647981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0995508-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN650413) |
| 163W00000X Registered Nurse (Licence: CO 164734) | |
| Enumeration Date | 2019-12-22 |
| Last Update Date | 2020-06-03 |