| NPI | 1033717996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.010014) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2288853) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2021-10-21 |