| NPI | 1861128241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 53266) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0992693-C-NP) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2024-05-02 |