| NPI | 1114328507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005901) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338443-1) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2021-03-09 |