| NPI | 1508142571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 14634) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 356466) |
| Enumeration Date | 2011-10-22 |
| Last Update Date | 2025-08-19 |