| NPI | 1063183499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 11768) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F348459-01) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2023-05-22 |