| NPI | 1750930822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 44615) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO C-APN.0105865-C-NP) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2026-02-19 |