| NPI | 1245512474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10459) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336866) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2022-11-30 |