| NPI | 1265283923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004868)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020001218)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: KS 5383440042)  | |
| Enumeration Date | 2024-04-01 | 
| Last Update Date | 2025-10-06 |