| NPI | 1023614286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 10643) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2273018) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2022-06-27 |