| NPI | 1588202048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025044688) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 411105) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-12-05 |