| NPI | 1326569450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2281279) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2019-06-27 |