| NPI | 1104410059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023004713) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2021044083) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2025-11-03 |