| NPI | 1053198820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 0998905) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CO 0998905) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CO 0998905) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CO 0998905) | |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |