| NPI | 1770133480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA 60997735) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0996120-NP) |
| Enumeration Date | 2019-09-14 |
| Last Update Date | 2022-07-18 |