| NPI | 1104539162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022045228) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013000967) |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2026-08-28 |