| NPI | 1861384174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2025050446) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 0000000000) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-12-12 |