| NPI | 1104365071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6947) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6947) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 6947) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2021-03-01 |