| NPI | 1518763960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025005026) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2025005026) |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-09-18 |