| NPI | 1316835176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 2025025564) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2025025564) |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-06-27 |