| NPI | 1245853787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9049) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 124276) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2024-08-15 |