| NPI | 1649878067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020029679) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2016020626) |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2026-02-26 |