| NPI | 1639824089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346367) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |