| NPI | 1629271119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA MA166385) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2019-09-13 |