| NPI | 1245909928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025038536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 196098) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2025-11-25 |