| NPI | 1629788799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 11278) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2023-01-13 |