| NPI | 1174075113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11039138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 089728) |
| 363L00000X Nurse Practitioner (Licence: RI APRN03284) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6821) | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2025-06-03 |