| NPI | 1346575438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 4226) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT pending) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2020-04-02 |