| NPI | 1629627708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 14758) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F349466) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2025-08-20 |