| NPI | 1124737887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 13932) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5017236) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2025-01-21 |