| NPI | 1154786028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10025) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33 340209) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2021-11-02 |