| NPI | 1730829078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022008232) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022008232) | 
| Enumeration Date | 2022-04-01 | 
| Last Update Date | 2025-09-18 |