| NPI | 1922651322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704373321) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO APN.0994775-NP) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2022-01-19 |