| NPI | 1295251254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7185) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 12.007185) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2017-10-17 |