| NPI | 1174261044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022011643) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011016469) |
| Enumeration Date | 2022-05-21 |
| Last Update Date | 2026-07-13 |