| NPI | 1154069789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0999055-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 349691) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 15293) | |
| 163W00000X Registered Nurse (Licence: NY 741268) | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2025-12-12 |