| NPI | 1235741562 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025032063) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020014291) | 
| Enumeration Date | 2020-08-18 | 
| Last Update Date | 2025-09-04 |