| NPI | 1164144952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 10741) |
| 207Q00000X Family Medicine (Licence: CT 127754) | |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-11-10 |