| NPI | 1619658994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 12302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 210112) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-09-07 |