| NPI | 1194683763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2026012440) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018042600) |
| Enumeration Date | 2026-01-13 |
| Last Update Date | 2026-05-13 |