| NPI | 1942306279 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN0990481)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC000373)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: AK 868)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM R39257)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO RXN0100562)  | |
| Enumeration Date | 2006-09-15 | 
| Last Update Date | 2013-02-19 |