| NPI | 1407158488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 13021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169090) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2024-04-04 |