| NPI | 1255819348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007724) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 12.007724) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-16 |