| NPI | 1417711821 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12858) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 12858) | 
| Enumeration Date | 2024-02-07 | 
| Last Update Date | 2024-03-15 |