| NPI | 1558907220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 0995294) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0995294) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-08-03 |