| NPI | 1659184018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025001696) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2025001696) |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-12-02 |