| NPI | 1972159341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2109025801) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019025801) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2025-09-19 |