| NPI | 1336038454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025054124) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: MO 2024049007) |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2026-03-08 |