| NPI | 1053706499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6076) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 006076) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-05-16 |