| NPI | 1144652850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2012040822) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2003003852) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2025-08-18 |