| NPI | 1225819048 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023039046) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2023039046) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2023039046) | |
| Enumeration Date | 2023-10-09 | 
| Last Update Date | 2025-09-22 |