| NPI | 1205258605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 5676) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F338355) |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2022-08-02 |