| NPI | 1609273978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005358) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010034) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2018-04-10 |