| NPI | 1184358194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022027096) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2016025571) | 
| Enumeration Date | 2022-07-14 | 
| Last Update Date | 2022-08-01 |