| NPI | 1619580263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CT 12.009146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 12.009146) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 9146) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CT 9146) | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2022-04-06 |