| NPI | 1063700995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 4784) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CT E55652) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2025-12-01 |