| NPI | 1619795796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 14053) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 351594) |
| Enumeration Date | 2024-09-28 |
| Last Update Date | 2024-11-13 |