| NPI | 1487195863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6839) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CT 61765) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2020-06-10 |