| NPI | 1265083513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 008541) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 122599) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2021-11-17 |