| NPI | 1154885804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002709) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9655562) |
| 363L00000X Nurse Practitioner (Licence: AZ 308247) | |
| 363L00000X Nurse Practitioner (Licence: CO C-APN.0102110-C-NP) | |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2025-03-27 |