| NPI | 1619577574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 9271) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 9271) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-12-10 |