| NPI | 1518040013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003067) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F333590) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2023-03-07 |