| NPI | 1174060784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11160) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 341216) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1055860) | |
| Enumeration Date | 2017-01-21 |
| Last Update Date | 2024-11-06 |