| NPI | 1629946546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2026003644) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MO 2017021460) |
| Enumeration Date | 2025-10-23 |
| Last Update Date | 2026-01-27 |