| NPI | 1679399612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO F07241377) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10044592) |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2026-05-07 |