| NPI | 1174009641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7749) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 000) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-08-07 |