| NPI | 1417574930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 11414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2298812) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2024-12-03 |