| NPI | 1063147627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10802) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 173595) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2025-01-07 |