| NPI | 1174099410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11196) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN238647) |
| Enumeration Date | 2018-10-14 |
| Last Update Date | 2025-05-05 |