| NPI | 1043687460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 006256) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2020-03-13 |