| NPI | 1790527570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023189775) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2024011236) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2025-07-28 |