| NPI | 1992089676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 990115) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 178183) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2015-12-04 |