| NPI | 1720421514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025006307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000024135) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2025-09-17 |