| NPI | 1679445159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2025041504) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO 2025041504) |
| 208D00000X General Practice (Licence: MO 2025041504) | |
| 208800000X Urology (Licence: MO 2025041504) | |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-10-30 |