| NPI | 1992051270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0994700-NP) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2020-10-25 |