| NPI | 1669213047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 6961570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO APN.0999756-NP) |
| Enumeration Date | 2024-06-01 |
| Last Update Date | 2025-06-30 |