| NPI | 1376435610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 14904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 14904) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2026-03-31 |