| NPI | 1366993164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 6783) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 6783) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CT 6783) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-09-09 |