| NPI | 1154103448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12752) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 350630) |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2024-03-15 |