| NPI | 1265923288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7562)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7562)  | 
| Enumeration Date | 2018-05-24 | 
| Last Update Date | 2025-02-05 |