| NPI | 1376074054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017007848) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017007848) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-09-19 |