| NPI | 1235741109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS F02210788) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 904483) | 
| 163W00000X Registered Nurse (Licence: MS R894543) | |
| Enumeration Date | 2020-08-20 | 
| Last Update Date | 2025-09-01 |