| NPI | 1164516670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 5266) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 335063) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-02-08 |