| NPI | 1164551214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 10024559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 10024559) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-02-05 |