| NPI | 1124398136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004866) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12004866) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2021-05-27 |